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8 - General debility and lack of stamina - CCMTA Medical Standards

Last updated on January 25, 2021

General debility, lack of stamina and medical fitness to drive.

8.1 About general debility and lack of stamina

General debility

General debility is a state of general weakness or feebleness that may be a result or an outcome of one or more medical conditions that produce symptoms such as pain, fatigue, cachexia and physical disability, or deficits in attention, concentration, memory, development and/or learning.

Some of the medical conditions included in this part may be commonly associated with general debility (e.g. end stage renal disease), and in these cases this is noted in the medical condition chapter.  However, general debility is more usually associated with multiple medical conditions or extreme old age.  Medications used to treat various medical conditions may also produce effects that contribute to general debility.

Common medical conditions not included in this document that may result in general debility are:

  • Anorexia nervosa or other related eating disorders
  • Chronic fatigue syndrome
  • Malabsorption syndromes (e.g. cystic fibrosis, Crohn’s disease) and malnutrition
  • AIDS
  • Chronic infections (e.g. TB, HIV)
  • Malignancies, and
  • Conditions resulting in chronic pain
  • Metabolic diseases such as: thyroid diseases, pituitary diseases and adrenal diseases

Lack of stamina

Stamina is the physical or mental strength to resist fatigue and tiredness and maintain functional ability over time.  Lack of stamina is not the same as general debility. While drivers with general debility do not have sufficient stamina to drive, drivers suffering from a lack of stamina may not be suffering from general debility.

Generally, concerns about stamina only arise in extreme old age or when a driver has a condition that results in a persistent impairment.  For drivers with co-morbidities, stamina may be a particular concern.

Some of the medical conditions in this part may be commonly associated with a lack of stamina (e.g. congestive heart failure), and in these cases this is noted in the medical condition chapter.

8.2 Prevalence

No data are available on the prevalence of general debility or lack of stamina in Canada.

8.3 General debility, lack of stamina and adverse driving outcomes

No research is available on the relationship between general debility or a lack of stamina and driving outcomes.

8.4 Effect on functional ability to drive

Condition Type of driving impairment and assessment approach Primary functional ability affected Assessment tools

General debility

Lack of stamina

 Persistent impairment: Functional assessment Cognitive  and Motor

Medical assessments

Functional assessments

Both a lack of stamina and general debility may impair a driver’s motor and/or cognitive functions necessary for driving.

A driver suffering from a lack of stamina may experience:

  • Fatigue
  • Physical disability, and/or
  • Cognitive impairment such as loss of attention, concentration and memory.

A driver suffering from general debility may experience:

  • Pain
  • Fatigue/poor stamina
  • Cachexia - a condition marked by loss of appetite, weight loss, muscular wasting, and general mental and physical debilitation
  • Physical disability, and/or
  • Cognitive impairment such as loss of attention, concentration and memory

8.5 Compensation

A driver cannot compensate for general debility or a lack of stamina that impairs the functions necessary for driving.

8.6 Guidelines for assessment

8.6.1 Frailty, weakness or general debility

National Standard

All drivers eligible for a licence if:

  • The results of a functional assessment indicate that the functions necessary for driving are not impaired
BC Guidelines

If the treating physician indicates that an individual has general debility, frailty, reduced reaction time, lack of stamina or weakness:

  • RoadSafetyBC may request an on-road assessment
Conditions for maintaining licence None
Reassessment RoadSafetyBC will re-assess every two years, unless information of file indicates earlier follow up is indicated, or the treating physician recommends annual re-assessment
Information from health care providers
  • Description of any cognitive and/or motor impairments
  • Results of Functional Assessment
Rationale Frailty, weakness or general debility may include one or more cognitive or motor impairments.  Licensing decisions should be based on individual functional assessments